Dataset Information

Independent risk factors of COVID-19 pneumonia in vaccinated Mexican adults.

ABSTRACT:

Objectives

To evaluate host factors associated with the risk of coronavirus disease 2019 (COVID-19) pneumonia in vaccinated adults.

Methods

A cohort study was conducted in Mexico, and data from 1607 adults with confirmed illness, with a positive history of COVID-19 vaccination, were analyzed. Risk ratios (RR) and 95% confidence intervals (CI) were computed as a measure of the significance of the associations between putative risk factors and the prevalence of COVID-19 pneumonia in vaccinated subjects.

Results

The overall risk of pneumonia was 1.98 per 1000 person-days. In the multiple regression analysis, older subjects, those with a history of smoking (current), obesity, and type 2 diabetes mellitus were at increased risk of pneumonia.

Conclusions

Our results suggest that the effectiveness of COVID-19 vaccines may be reduced in a subset of adults who are older aged, smokers, obese, or have type 2 diabetes mellitus.

SUBMITTER: Murillo-Zamora E

PROVIDER: S-EPMC8839797 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Independent risk factors of COVID-19 pneumonia in vaccinated Mexican adults.

Murillo-Zamora Efrén E Sánchez-Piña Ramón Alberto RA Trujillo Xóchitl X Huerta Miguel M Ríos-Silva Mónica M Mendoza-Cano Oliver O

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 20220212

<h4>Objectives</h4>To evaluate host factors associated with the risk of coronavirus disease 2019 (COVID-19) pneumonia in vaccinated adults.<h4>Methods</h4>A cohort study was conducted in Mexico, and data from 1607 adults with confirmed illness, with a positive history of COVID-19 vaccination, were analyzed. Risk ratios (RR) and 95% confidence intervals (CI) were computed as a measure of the significance of the associations between putative risk factors and the prevalence of COVID-19 pneumonia in ...[more]

PMID: 35167967

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Project description:Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76%) who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL), and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample) were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16-22.62, p < 0.001), daily oxygen therapy (OR = 8.29, 95% CI: 4.39-15.65), feeding support dependency (OR = 8.10, 95% CI: 6.27-10.48, p < 0.001), and urinary catheterization (OR = 4.08, 95% CI: 2.81-5.91, p < 0.001). In the multiple logistic regression analysis, the risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each) were sputum suctioning (OR = 3.276, 95% CI: 1.910-5.619), deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948-6.952), dehydration (OR = 8.019, 95% CI: 2.720-23.643), and dementia (OR = 1.618, 95% CI: 1.031-2.539).The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing repetitive aspiration pneumonia.

Project description:ImportanceWith a large proportion of the US adult population vaccinated against SARS-CoV-2, it is important to identify who remains at risk of severe infection despite vaccination.ObjectiveTo characterize risk factors for severe COVID-19 disease in a vaccinated population.Design, setting, and participantsThis nationwide, retrospective cohort study included US veterans who received a SARS-CoV-2 vaccination series and later developed laboratory-confirmed SARS-CoV-2 infection and were treated at US Department of Veterans Affairs (VA) hospitals. Data were collected from December 15, 2020, through February 28, 2022.ExposuresDemographic characteristics, comorbidities, immunocompromised status, and vaccination-related variables.Main outcomes and measuresDevelopment of severe vs nonsevere SARS-CoV-2 infection. Severe disease was defined as hospitalization within 14 days of a positive SARS-CoV-2 diagnostic test and either blood oxygen level of less than 94%, receipt of supplemental oxygen or dexamethasone, mechanical ventilation, or death within 28 days. Association between severe disease and exposures was estimated using logistic regression models.ResultsAmong 110 760 patients with infections following vaccination (97 614 [88.1%] men, mean [SD] age at vaccination, 60.8 [15.3] years; 26 953 [24.3%] Black, 11 259 [10.2%] Hispanic, and 71 665 [64.7%] White), 10 612 (9.6%) had severe COVID-19. The strongest association with risk of severe disease after vaccination was age, which increased among patients aged 50 years or older with an adjusted odds ratio (aOR) of 1.42 (CI, 1.40-1.44) per 5-year increase in age, such that patients aged 80 years or older had an aOR of 16.58 (CI, 13.49-20.37) relative to patients aged 45 to 50 years. Immunocompromising conditions, including receipt of different classes of immunosuppressive medications (eg, leukocyte inhibitor: aOR, 2.80; 95% CI, 2.39-3.28) or cytotoxic chemotherapy (aOR, 2.71; CI, 2.27-3.24) prior to breakthrough infection, or leukemias or lymphomas (aOR, 1.87; CI, 1.61-2.17) and chronic conditions associated with end-organ disease, such as heart failure (aOR, 1.74; CI, 1.61-1.88), dementia (aOR, 2.01; CI, 1.83-2.20), and chronic kidney disease (aOR, 1.59; CI, 1.49-1.69), were also associated with increased risk. Receipt of an additional (ie, booster) dose of vaccine was associated with reduced odds of severe disease (aOR, 0.50; CI, 0.44-0.57).Conclusions and relevanceIn this nationwide, retrospective cohort of predominantly male US Veterans, we identified risk factors associated with severe disease despite vaccination. Findings could be used to inform outreach efforts for booster vaccinations and to inform clinical decision-making about patients most likely to benefit from preexposure prophylaxis and antiviral therapy.

Project description:Pneumonia, an acute respiratory tract infection, is one of the major causes of mortality worldwide. Depending on the site of acquisition, pneumonia can be community acquired pneumonia (CAP) or nosocomial pneumonia (NP). The risk of pneumonia, is partially driven by host genetics. CYP1A1 is a widely studied pulmonary CYP family gene primarily expressed in peripheral airway epithelium. The CYP1A1 genetic variants, included in this study, alter the gene activity and are known to contribute in lung inflammation, which may cause pneumonia pathogenesis. In this study, we performed a meta-analysis to establish the possible contribution of CYP1A1 gene, and its three variants (rs2606345, rs1048943 and rs4646903) towards the genetic etiology of pneumonia risk. Using PRISMA guidelines, we systematically reviewed and meta-analysed case-control studies, evaluating risk of pneumonia in patients carrying the risk alleles of CYP1A1 variants. Heterogeneity across the studies was evaluated using I2 statistics. Based on heterogeneity, a random-effect (using maximum likelihood) or fixed-effect (using inverse variance) model was applied to estimate the effect size. Pooled odds ratio (OR) was calculated to estimate the overall effect of the risk allele association with pneumonia susceptibility. Egger's regression test and funnel plot were used to assess publication bias. Subgroup analysis was performed based on pneumonia type (CAP and NP), population, as well as age group. A total of ten articles were identified as eligible studies, which included 3049 cases and 2249 healthy controls. The meta-analysis findings revealed CYP1A1 variants, rs2606345 [T vs G; OR = 1.12 (0.75-1.50); p = 0.02; I2 = 84.89%], and rs1048943 [G vs T; OR = 1.19 (0.76-1.61); p = 0.02; I2 = 0.00%] as risk markers whereas rs4646903 showed no statistical significance for susceptibility to pneumonia. On subgroup analysis, both the genetic variants showed significant association with CAP but not with NP. We additionally performed a spatial analysis to identify the key factors possibly explaining the variability across countries in the prevalence of the coronavirus disease 2019 (COVID-19), a viral pneumonia. We observed a significant association between the risk allele of rs2606345 and rs1048943, with a higher COVID-19 prevalence worldwide, providing us important links in understanding the variability in COVID-19 prevalence.

Project description:ObjectivePatients with hematological malignancies have an elevated risk of developing pneumonia after contracting COVID-19. Lymphoma is the most prevalent hematologic malignancy. It is critical to identify patients at high risk of contracting COVID-19-associated pneumonia.MethodsFrom January 11-31, 2023, we distributed questionnaires to patients diagnosed with lymphoma according to 2016 World Health Organization diagnostic and classification criteria. COVID-19 infection was confirmed based on symptoms and laboratory tests. Pneumonia was confirmed using computed tomography scans.ResultsIn total, 257 patients were included in this study; 221 patients (86.0%) had COVID-19 infection and 61 (27.6%) of these had pneumonia. Patients with B-cell non-Hodgkin lymphoma (B-NHL) had a significantly higher pneumonia incidence than patients with other lymphoma types (31.8% vs. 27.6%, P=0.005). Higher incidence of pneumonia was observed in patients receiving anti-CD20 therapy (30.0% vs. 16.3%, P=0.048) and Bruton's tyrosine kinase (BTK) inhibitor therapy (51.3% vs. 22.5%, P=0.001). B-NHL (hazard ratio [HR]=3.7, 95% confidence interval [CI] 1.4-10.0, P=0.009), anti-CD20 therapy (HR=2.3, 95% CI 1.0-5.2, P=0.050), BTK inhibitor (HR=3.6, 95% CI 1.8-7.4, P<0.001), active therapy (HR=3.0, 95% CI 1.5-5.7, P=0.001), and lack of disease remission (HR=3.7, 95% CI 1.8-7.4, P=0.001) were high-risk factors for developing pneumonia. Anti-PD-1 therapy was a protective factor against pneumonia development (HR=0.2, 95% CI 0.05-0.9, P=0.034). In multivariable analysis, BTK inhibitor (HR=3.5, 95% CI 1.6-8.0, P=0.003), active therapy (HR=3.3, 95% CI 1.6-6.8, P=0.001), and disease non-remission (HR=2.9, 1.3-6.4, P=0.007) were independent risk factors for pneumonia development after COVID-19 infection in patients with lymphoma.ConclusionsPatients with lymphoma receiving BTK inhibitors, undergoing active therapy, and lacking disease remission exhibited a higher risk for pneumonia associated with COVID-19.

Dataset Information

Independent risk factors of COVID-19 pneumonia in vaccinated Mexican adults.

Objectives

Methods

Results

Conclusions

Publications

Independent risk factors of COVID-19 pneumonia in vaccinated Mexican adults.

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